Basic Information
| Provider Information | |||||||||
| NPI: | 1568449742 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STERN | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10100 FOREST HILLS RD | ||||||||
| Address2: | |||||||||
| City: | MACHESNEY PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611158234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157132600 | ||||||||
| FaxNumber: | 8156548020 | ||||||||
| Practice Location | |||||||||
| Address1: | 403 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BELGRADE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597143847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063888708 | ||||||||
| FaxNumber: | 4063888710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DR.0056916 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 29585 | MT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.